iDose®TR (travoprost intracameral implant)

Covered for intracameral use in adults (≥18) with open‑angle glaucoma or ocular hypertension when placed by or under the supervision of an ophthalmologist, but excluded for patients <18 or for re‑treatment of an eye previously treated with iDose TR and limited to one implant per treated eye (max two implants per patient). Prior documentation is required showing diagnosis, that the eye has not had prior iDose TR, and inadequate efficacy or severe adverse events to at least two ophthalmic prostaglandins and to at least two products from two different pharmacologic classes; requests exceeding dosing limits require justification.

"Is 18 years of age or older;"

Sign up to see full coverage criteria, indications, and limitations.